Welcome to the Committee on Dental Auxiliaries

Registered Dental Hygienists Allowable Duties and Frequently Asked Questions

Allowable Duties

Law and regulation specifically define the duties that each category of auxiliary is allowed to perform, the level of dentist supervision required, and the settings in which the duties may be performed. It is a criminal offense to perform illegal functions, as well as grounds for license discipline of both the person performing the illegal function and any person who aid or abets such illegal activity.

The duties and responsibilities that RDHs are allowed to perform are specified in Sections 1760 through 1765 of the Business and Professions Code.

Regulations Section 1088 must be disregarded, as it is superceded by statute, Business and Professions Sections 1760 – 1765.

You may download or purchase a publication of our laws and regulations.

Following are highlights of the laws:

First, Section 1764(b) allows a RDH to provide allowable dental hygiene services in any setting, provided that he or she does so under the appropriate level of supervision defined by law.

Section 1764(a) also provides that any procedure or service provided by a RDH that does not specifically require direct supervision (delineated in Section 1761) shall require general supervision. A service which does not require direct supervision may be provided under general supervision so long as it does not give rise to a situation in the dentist's office requiring immediate services for alleviation of severe pain, or immediate diagnosis and treatment of unforeseeable dental conditions which, if not immediately diagnosed and treated, would lead to serious disability or death.

In addition, the new laws place a broad definition of dental hygiene practice in statute. Section 1760.5 provides that broad definition, as well as the duties and services which a registered dental hygienist is prohibited from providing. Sections 1761 and 1762 specify the duties which must be performed under direct supervision and those which may be performed under general supervision.

The practitioner and his or her supervising dentist must determine whether a procedure or service to be performed under general supervision (other than those specifically listed in Section 1762) correctly meets the broad definition of dental hygiene contained in Section 1760.5. For example, although the act of performing a mouth-mirror inspection of the oral cavity and associated charting are not specifically listed as an allowable procedure in Section 1762, it is obviously a procedure that would fall within the broad definition contained in Section 1760.5.

Section 1763(a) provides that a RDH may provide, without supervision, educational services, oral health training programs, and oral health screenings. The RDH must refer any screened patient with possible oral abnormalities to a dentist. As stated above, section 1764(b) specifies that these services can be provided in any setting.

In addition, Section 1763(c) provides that in any public health program created by federal, state or local law or administered by a federal, state, county, or local government entity, a RDH may also provide, again without supervision, dental hygiene preventive services in addition to oral screenings.

Section 1763 does not provide a definition of "preventive services," other than to state that they include, but are not limited to, the application of fluorides and pit and fissure sealants. However, it would seem that the term "preventive services" would include those duties that would fall within the broad scope of dental hygiene defined by Section 1760.5 (dental hygiene assessment and development of a dental hygiene care plan).

In addition, it would appear that the allowable duties would also specifically include the preventive services listed in Section 1762(a) and (b), as follows:

(a) Preventive and therapeutic interventions, including oral prophylaxis, scaling, and root planing; (Section 1762(a)) and,

(b) Application of topical, therapeutic, and subgingival agents used for the control of caries and periodontal disease (Section 1762(b)).

The practitioner must determine whether a procedure or service to be performed without supervision in the specified public health program (other than those specifically listed in Section 1762(a) and (b)) correctly meets the definition of a "preventive service" specified in Section 1763(c).

Patients receiving the services of a RDH without the supervision or direction of a dentist as provided in Section 1763 would not need to meet the requirements of Section 1684.5 that he or she be a patient of record of a licensed dentist.

Frequently Asked Questions

Following are frequently asked questions about allowable duties:

  • May RDHs place antibiotic medicaments subgingivally?
    • The new laws provide a broad definition of dental hygiene practice, which would allow the performance of this procedure.
  • May auxiliaries use slow or high-speed hand pieces?
    • The use of a slow-speed or high-speed hand piece by auxiliaries is not specifically prohibited by law or regulation, except that (1) those certified to perform coronal polishing are limited to using "an appropriation rotary instrument with rubber cap or brush and a polishing agent" (Regulation Section 1067(h); and (2) the procedure is not intended to cut hard or soft tissue.
    • However, law also prohibits dental personnel from performing any service which they are not competent to perform, or which is not in accordance with customs and standards of the dental profession, as provided in Section 1684 of the Dental Practice Act:
    • "1684. In addition to other acts constituting unprofessional conduct under this chapter, it is unprofessional conduct for a person licensed under this chapter to perform, or hold himself or herself out as able to perform, professional services beyond the scope of his or her license and field or fields of competence as established by his or her education, experience, training, or any combination thereof. This includes, but is not limited to, the use of any instrument or device in a manner that is not in accordance with the customary standards and practices of the dental profession..."
    • Therefore, it is up to the practitioner and his or her employer to assure that the above requirements are fully met before using a device to avoid disciplinary and/or criminal action.
  • May an RDH use lasers?
    • RDHs may use a laser if it is used in accordance with the customary standards and practice of the dental community. They can only use a laser which has been approved by the FDA for the particular procedure they intend to perform with the laser, AND they only can perform the procedure if it is one that currently law and regulations currently allows them to perform.
    • No auxiliary may provide ANY service, including the use of a laser, if doing so would be beyond the scope of their education, experience and training (see Section 1684 of the Business and Professions Code in the publication of laws and regulations referred to above).
  • Who may perform coronal polishing, and when? Is coronal polishing considered an oral prophylaxis?
    • An unlicensed dental assistant may not perform coronal polishing. Only a licensed RDA may perform coronal polishing, AFTER successful completion of a Board-approved course and submission of certification thereof to COMDA.
    • A licensed dentist or registered dental hygienist must determine that the teeth to be polished are free of calculus or other extraneous material PRIOR to coronal polishing (See Regulation Section 1086(d)(12).
    • Coronal polishing may not be intended or interpreted as a complete oral prophylaxis, which is a procedure which can be performed only by a licensed dentist or registered dental hygienist
    • An oral prophylaxis is defined in Regulation Section 1067(g) as"Oral prophylaxis' means the preventive dental procedures including complete removal of explorer-detectable calculus, soft deposits, plaque, stains, and the smoothing of unattached tooth surfaces. The objective of this treatment shall be creation of an environment in which hard and soft tissues can be maintained in good health by the patient."

For specific questions about the RDH Application or Examination, please email laura_fisher@dca.ca.gov.